Anatomy
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What is the Distal Phalanx?

Alex Paul
Alex Paul

A distal phalanx is a bone at the end of both the fingers and toes. Distal phalanges shape the nails of a human hand or foot and hence are also called ungula phalanges. It is not uncommon for them to be called terminal phalanges either in reference to the bones location at the end of the digits. The bones are shaped to support the finger. In humans, a distal phalanx is usually a flatter and wider bone compared to other mammals.

A phalanx that occurs at the end of human fingers is distinguishable by a mixture of flat and convex surfaces. The surface of a distal phalanx on a finger is horseshoe shaped so that it can support the flesh and vulnerable parts. Human fingers also contain apical tufts, which are wide openings that support the nail and finger.

A finger splint may be used to support the distal phalanx and the rest of the finger.
A finger splint may be used to support the distal phalanx and the rest of the finger.

A distal phalanx of the toe is usually very similar to that of the finger aside from a few small differences. Firstly, a toe distal phalanx is smaller than a finger phalanx. Also, the toe phalanges are flattened on the top and come with a larger end in order for them to fit and support the nail. They also have a large base that allows the bone to connect correctly to the second set.

The distal phalanx in the hand is located at the tips of the fingers.
The distal phalanx in the hand is located at the tips of the fingers.

Many mammals have similar distal phalanges although there are a large number of variations. For example, the apical tufts in other mammals can vary in size. This is thought to be an evolutionary response to the need for tool making. A human distal phalanx, however, is always larger than the phalanx of any other mammal.

Due to the distal phalanges close proximity to the end of the finger, injuries are likely. Distal phalanx fractures, for example, are very common and are often caused by the finger being crushed. In general a fracture to a distal phalanx won’t require surgical intervention although this depends on the severity of the injury. Immobilizing the phalanx for several weeks usually helps to ease the pain and allow for faster healing although isn’t always required.

A distal phalanx in the toes is typically shorter than one in the fingers.
A distal phalanx in the toes is typically shorter than one in the fingers.

Other potential injuries to a terminal phalanx include mallet finger, nail bed injuries and Jersey finger. The treatment for these injuries depends on the exact type as well as the severity of the problem. Immobilization is often used for a number of different types of injury though as this allows the joint a greater time to heal.

Discussion Comments

Oceana

In high school, my boyfriend played football. He suffered from jersey finger. The name comes from what usually is going on when the injury occurs.

He had grasped another player’s jersey to tackle him. The guy wrestled away, and his tendon snapped back along the base of his finger.

He could not bend his finger into his palm after that. When he rested his hand, that finger straightened out, while the others flexed naturally.

He had to have the tendon reattached. His doctor drilled holes in the bone of his finger. Then, he pulled sutures through the holes and the fingernail. He tied them over a button on the back of his finger.

seag47

I injured the distal phalanx of my big toe, and I lost part of my nail because of it. This is a very painful area to injure, because it has lots of nerve endings.

I was helping my friend move into her new apartment. I had picked up a heavy box of books, and while I was carrying it across the yard, a red wasp stung me in the nose. Instinctively, I swatted at it, and of course, I dropped the box on my toe.

The pain was intense for hours, but it eventually went away, and I didn’t even notice that my nail was damaged until a month later. My boyfriend and I were floating in the swimming pool when he pointed out that my toenail had a crack across it about midway. He nudged it, and it moved!

I was afraid it would hurt when it came off, but it was totally painless. He tugged at it gently, and half of my nail came off in his fingers.

OeKc05

My guitarist friend was playing football with his friends when the ball struck the tip of his finger. He was afraid that it was broken and he would never be able to play guitar again, because he could not straighten it. However, it happened on a weekend, and he didn’t want to go to the hospital, so he waited until Monday to go to his doctor.

Over the weekend, his finger became swollen and bruised. The tip drooped and hurt a lot. He put ice on it to ease the pain, and elevating it seemed to help as well.

His doctor gave him a splint to hold it straight. He had to wear it for eight weeks constantly, and after that, he put it on at night for three more weeks. Today, he has regained full use of his fingertip.

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    • A finger splint may be used to support the distal phalanx and the rest of the finger.
      By: Rob Byron
      A finger splint may be used to support the distal phalanx and the rest of the finger.
    • The distal phalanx in the hand is located at the tips of the fingers.
      By: Alila Medical Media
      The distal phalanx in the hand is located at the tips of the fingers.
    • A distal phalanx in the toes is typically shorter than one in the fingers.
      By: schankz
      A distal phalanx in the toes is typically shorter than one in the fingers.
    • Injuries to the distal phalanx of the foot may require bandaging to prevent further injury and promote healing.
      By: NorGal
      Injuries to the distal phalanx of the foot may require bandaging to prevent further injury and promote healing.
    • While the proximal and middle phalanges in the fingers are similar in length, the proximal phalanges in the toes are significantly longer that the middle and distal bones.
      By: Grasko
      While the proximal and middle phalanges in the fingers are similar in length, the proximal phalanges in the toes are significantly longer that the middle and distal bones.
    • X-rays may be conducted to diagnose a fractured distal phalanx.
      By: stokkete
      X-rays may be conducted to diagnose a fractured distal phalanx.